Objective: We aimed to compare the surgical outcomes of the mini-open and closed reduction approaches in the treatment of femoral shaft fractures in children between the ages of 6 and 12.

Material and Method: We reviewed retrospectively a total of 34 patients who were performed surgery due to femoral shaft fractures from 2013 to 2016. The mean age of the patients was 7,7 and follow-up duration was 16 months. Titanium elastic nail was performed the intramedullary fixation after closed reduction in 16 and after mini-open approach in 18 of patients. All patients were made long leg cast-plaster and it was removed on the 15th day in 28 of patients and in the 6th week in 6 of patients. All patients were discharged on the average of 2,9 days and called for follow-up. It was compared clinical and radiological results of patients including intraoperative evaluation for both approaches.

Results: Fracture healing in all patients were obtained. There were excellent and successful results in 16 of the closed reduction and in 18 of the mini-open approach. There was no difference between both approaches in terms of duration, healing, length difference and angulation. The exposure to radiation and duration of the surgery in mini-open approach was less, but hospital stay was longer.

Conclusion: Titanium elastic nail is a good option in treatment of the femoral shaft fractures in children. Insisting on achieving closed reduction during surgery increases the radiation exposure of both surgical team and patients, and also prolongs duration of the surgery.